Temporomandibular Joint (TMJ)

Recover from Temporomandibular Joint (TMJ) Pain for good.

TMJ Pain occurs when the muscles, ligaments, capsule, and disc of the joint become inflamed or irritated. Physical Therapy can eliminate TMJ pain by normalizing the mechanics of the joint, decreasing inflammation and eliminating trigger points via manual therapy, dry needling, and joint mobilizations and manipulations.

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What is Temporomandibular Dysfunction?

  • According to a study by Kumar et al, 81.8% of patients with TMD experience a displacement of the articular disc, and a majority of the time, this displacement occurs in the anterior direction. This disruption typically involves degeneration of the posterior joint capsule, which leads to a significant imbalance of the muscles of the mastication. Physical therapy can assist in normalizing this imbalance.
  • According to the National Institute of Health and Cranial Research, the prevalence of TMD ranges from 5-12%
  • Genetic, pathoanatomic, and hormonal factors can lead to TMD, but trauma, habitual activity, occlusal variation, and psychosocial issues play a strong role in the condition.

TMJ Dysfunction

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How can Physical Therapy help?

  • Non-thrust mobilization and high-velocity, low amplitude thrust manipulation of the temporomandibular joint has been shown to increase joint range of motion and pain while decreasing hypertonic activity of the muscles of mastication.
  • Non-thrust mobilization and high-velocity, low amplitude thrust manipulation of the cervical spine helps to inhibit pain and quiet hypertonic muscles of mastication by rebalancing the trigeminal nerve in the trigeminocervical nucleus of the brainstem.
  • Multiple systematic reviews have reported a reduction in pain and disability associated with myofascial trigger points in muscles of mastication following dry needling.

 

  • Dry needling has been shown to increase blood flow to the temporomandibular joint, facilitating the recruitment of opioid producing cells required to reduce inflammatory factors.  There is also some evidence that suggests that dry needling inhibits osteoclast activity while increasing lubricating hyaluronic acid, thereby improving the overall health of the temporomandibular joint.
  • Winback technology has been shown to activate mitochondria to produce ATP while normalizing cell excitability and membrane transport, which are crucial components of temporomandibular tissue repair.
  • Stretching, relaxation, strengthening, and endurance of muscles of mastication has been shown to improve neuromuscular control of the temporomandibular joint, thereby decreasing joint clicking, spasming, and asymmetry.
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Significant decrease in jaw painpost PT treatment compared to prescription NSAIDs and interocclusal splint therapy

Significantly less inflammation associated with TMD

Better long-term, functional outcomes for TMD than BOTOX injections

Significant improvement in measurement of jaw opening

Improved activation and strength of muscles of mastication

Benefits of Multi-modal Physical Therapy for Temporomandibular Dysfunction (TMD) AT A GLANCE

Decrease in headaches related to TMD

Improved mechanotransduction of peri-articular connective tissue associated with the temporomandibular joint

Reduced temporomandibular degeneration via increased vasodilation and lubrication of the joint

Neurophysiologic desensitization of the temporomandibular joint

Improved temporomandibular joint mechanics

Bottom Line:

  • Physical therapy is the preferred approach for temporomandibular dysfunction, as it provides a multimodal treatment strategy that is patient specific and targets the anatomical structures that are associated with the patho-anatomy of the condition.
  • Multi-modal physical therapy has been shown to improve pain and disability associated with temporomandibular dysfunction for >6 months following treatment.
  • In a multi-clinical site randomized control trial by Dunning et al, multimodal physical therapy has been shown to be more effective than interocclusal splint therapy and prescription NSAIDs for TMD.
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About

Symmetry Physical Therapy is a privately owned one-on-one, patient-centered physical therapy clinic in Downtown Miami/Brickell. Every treatment is with the same Doctor of Physical Therapy for the entire hour. Symmetry’s specialized, dedicated, and passionate team of professionals is fully committed to each patient’s success.

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